Further to the removal of my thyroid in September, I've recently received the results from the second round of blood tests since the surgery. I asked if they could also check my B12 and Ferritin. After the first check my Levothyroxine dose was changed from 150mcg every day to an increase Fri-Sun to 175mcg.
Unfortunately ranges were not given for the recent tests but I'm assuming they are the same as the last test:
T4 26.2 (10.0-23.0 pmol/L) (previously it was 18.3)
T3 4.4 (3.1-6.8 pmol/L) (previously it was 2.8)
TSH 0.03 (0.27-4.20 mlU/L) (previously it was 7.48)
Adj Ca 2.38 (2.15-2.55 mmol/L) (previously it was 2.52)
PTH 28(10-65ng/L) (previously it was 13)
Ferretin 48 (not tested since 2018 when it was 78 ug/L)
B12 >128 (not tested since 2018 when it was 441ng/L)
I haven't spoken to anyone yet about the recent tests as the results were received in a letter recommending that my Levo dose should be changed to 150mcg every day with an increase Sat-Sun to 175mcg.
I would be grateful for any advice on the above, especially the B12 result which seems very low.
Thanks
Written by
FeelingBluey
To view profiles and participate in discussions please or .
B12 >128 (not tested since 2018 when it was 441ng/L)
I would want further clarification on this. Was it a Total B12 test, in which case the reference range for ng/L unit of measurement is something like 150-900 (my surgery's range) so why just put >128 rather than a proper result. If it's Active B12 then the range is a lot narrower, eg 37.5-188, and maybe the machine doesn't measure higher than 128. It needs an explanation.
Or have you given the correct symbol ">" which means greater than, and is it actually <128 which means less than? If it's Total B12 and the result is <128 then you are likely looking at B12 deficiency and further testing should be done, you may have Pernicious Anaemia, you may need B12 injections.
Ferretin 48 (not tested since 2018 when it was 78 ug/L)
This is too low. Below 30 is considered by NICE to be iron deficiency. Obviously it isn't in your case but it's still low. Maybe an iron panel can be done to exclude iron deficiency.
You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
Thanks and yes I do need clarification on the results from the hospital which I've asked for. The result for B12 was definitely written as > more than 128 but thanks for your explanation on the different types of B12 tests which I wasn't aware of.
Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Do you always get same brand levothyroxine at each prescription
Thanks for your reply. The tests were done via the NHS hospital where I had the surgery, but due to long waiting times for appointments/tests and the distance I have to travel to the hospital, the tests were not undertaken until 2.30pm and so I ate a light breakfast before leaving home early in the morning. I have been prescribed the same brand of tablets so far.I'm still taking PPI but take the Levo when I wake usually in the early hours to go to the loo so there is a sufficient gap between the medications.
The results letter I received from the hospital didn't include vitamin D and folate levels so that is something else I need to check with them.
I only take the B12 meds I've been taking since 2018, which I think you previously said were not the right type so need to speak to my GP about that.
I've been suffering from palpitations lately plus more headaches and still have breathlessness.
B12 >128 (not tested since 2018 when it was 441ng/L)
B12 result is pretty meaningless
Just saying it’s higher than 128 is pathetic
Can you get private testing…..vitamin D, folate, B12
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Did you take levothyroxine in the night before your test?
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Just looking here - you are not converting the T4 into T3 and not metabolising which is evident as your ferritin and B12 have continued falling through the ranges.
The accepted conversion ratio when on T4 only is said to be 1 / 3.50 - 4.50 -- T3 / T4 :with most people feeling at their best when they come in at around 4 or under :
So to find your conversion ratio you simply divide your T3 into your T4 and looking at the above results I'm getting yours coming in at 5.95 showing you very wide of the range and struggling on monotherapy with T4.
Your T4 is coming in at around 125% through with your T3 at around 35% through :
T3 and T4 need to balanced within in their ranges and likely with T4 being in the top quadrant.
I've seen worse, so don't worry, but you would likely feel better with a T3/ T4 combo :
Your thyroid would have been supporting you daily with trace elements of T1. T2 and calcitonin plus a measure of T3 at around 10 mcg plus a measure of T4 at around 100 mcg.
T3 is said to be around 4 times more powerful than T4 with the average person needing to find / convert around 50 T3 daily just to function.
It is low T3 that causes all the symptoms of hypothyroidism and there is a list of symptoms on the Thyroid UK website should you wish to identify where you are in all this.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Latest blood test results 
Help With Blood Test Results
Blood test results in (finally)
Help with blood test results
Horrendous Blood Test Results
